A class with Professor Susana Constantino

We agreed that I could attend one of her practical Biochemistry classes. We scheduled it for 11 am. I arrive on time, but I find the door closed and I hear her voice inside. I get in with a thousand apologies, thinking to myself, how could I be late for my first class at Medical School?

In a room that only has workbenches, fridges and some machines that I am not familiar with yet, there are 9 students, all girls, all with updo hair. The Professor speaks enthusiastically and jigs as if trying to dribble past the exceeded class time limit. I wasn’t late after all, I was ahead of time plus, the first of two 1st year Science of Nutrition classes started late. The class conclusions are written with a marker on a white board. “Don’t forget to sleep well the night before our class, it’s very important not to be late, as you see two hours fly by.”

As the class ends they remove their lab coats in a hurry and with a serious look they quickly exit in order for the new class to fill the workbenches.

The Professor organises the room and prepares materials for the new class where she will repeat everything she has just finished teaching. Susana Constantino teaches biochemistry and leads the Angiogenesis Unit (blood vessel growth) at the University of Lisbon Medical School, she is a Researcher and Executive Director of the University of Lisbon Cardiovascular Centre (CCUL). She takes a deep breath and comes to the door in search of the new students that follow, she sees in every minute the necessary importance to fully comply with the content.

New faces begin to fill the room, this time there is a boy and another student who missed the previous hour and now comes to ask to attend this one. There’s a phone on the floor, the Professor asks if it belongs to someone, quickly one of the students claims it. In a well-paced and organised ritual, they put on the lab coats, it’s with their gloves that they have more difficulty, as if they were still an unusual prop. Phones are kept discreetly in the lab coat pockets and visited very punctually throughout the class when there are brief seconds of theme transitions.

“Don’t place personal items on the workbenches where blood has already been”, she says with ease of information that is particularly strange to me. No one else makes a curious or frightened air, I’m the only one who withers further into the corner at the end of the room and I lift my feet off the floor.

She finally makes the roll call and knows her students for the first time. The morning is cold and wintry, but the Professor feels the warmth of one’s boiling energy. For each name called she looks at them briefly and only once. A few minutes later I realise that she had just memorised all her students, associating each face with its name. “I need you to be punctual and for these classes to be dynamic and interactive”, she reinforces, putting some pressure on the start of class. What Susana Constantino didn’t know was that dynamics were an unnecessary request, because from the first minutes of silent ceremony, the effervescence of thought arose.

From the refrigerator she then takes two small tubes of blood, each workbench has a team and each team is supplied with blood, divided into two tubes; then they will be given the drabkin solution and the standard solution, which is fundamental to the chemical reactions that follow. The pipettes, which are used to aspirate and control the dosages of liquids to be placed in the test tubes, are already on the workbenches. “I want you to leave this class differently than when you came in. Questions only arise when we have time to think of something”. It’s not in vain that she is a Professor, Susana Constantino knows that it’s in the repetition of the trial versus error cycle that one acquires logical reasoning. She likes to have persistent, self-critical students, and even though she’s aware they will fail their first lab experiments, they will work on their reasoning, even if it’s based on an error. This is what will help them develop a series of ideas that one day can lead to the right result, or even new results so far undiscovered.

The first few minutes in that lab are filled with a silence that allows us to hear the machines working, especially when the students are asked if they studied and printed the protocol. The protocol should be the manual that guides them throughout the class. In the next 4 weeks it’s important that they adapt to this Professor’s rhythm because she doesn’t allow for indifference to settle in, especially with those who least want to stand out.

It is by comparing the blood tubes that they begin to apply and perceive the scientific terminology. It’s also when I realise that in a class there is always someone or some people who stand out, which doesn’t mean that reason always prevails.

“There is something forbidden in my classes and that is not understanding what’s being done”, says the Professor calmly. A student arrives late to the class and subtly slides to the vacant chair, but Susana Constantin doesn’t let her lose the thread of the class, she knows that from the moment someone asks a parallel question, to keep up with the thread, this will also distract the one who was already there from the beginning. They’re all in the same boat and no team is weaker because she doesn’t allow it, so if someone falls behind, everyone follows and pick up the pace from there.

There are two or three students ahead, coming up with solutions to what they should read in the blood tubes where different contrasts are mixed. As logic picks up, trust grows as well. “Is anyone lost?” The Professor asks, “Do not stop working, you can have your brain working and your hands moving at the same time.”

Someone in the class casts a doubt. “That was a great question on your part, keep them coming!”. Doubt fuels interest. The time passed brought some encouragement, the first steps were taken and some are taking them with more ease. Some write everything the Professor says, others focus mostly on listening. Professor becomes “Prof”, but it’s not with disrespect, it’s just the establishment of the first bonding ties.

The tubes of blood go in the centrifuge, to isolate elements that constitute it and to take readings. The groups exchange the tubes, lose the order, resume it after some comparisons. “It’s fine, it’s cool”, one of the students replies to calm her work group.

When simplifying the data Susana Constantino manages to pull the group into her reasoning. “We leave the lab and go to the kitchen and make a cake, we weigh ingredients one by one”.

Here and there someone discreetly stands up to drink water, always on the opposite side of the place where they sit in the room. It’s in these small details that one realises that they respect the hierarchy and the rules of the class.

There are 5 minutes left for the class to finish, some groups have concluded the experiment with more agility, conclusions are exchanged, but there is always a spirit of mutual help. The same recurrent female voice in the group states, “c’mon guys, I’m getting hungry.” The teacher reinforces time management, “if classes do not start on time, the protocols are not completed, do you understand the importance of arriving on time?”.

They did understand and were motivated. Some still bring too many personal convictions, they’re sure of themselves, even when they fail they try to find new arguments that enrich Science; others prefer that no one sees them. It is in the balance of personalities that they compensate each other. Even before they saw the final results, which were validated by the Professor, everyone wanted to present their own readings and draw probable conclusions.

The class is over, the lab coats are quickly undressed, but almost all of them are folded with special care, as if it were a rare and delicate piece. They let their hair down and throw the gloves in the trash. The classroom is empty in seconds. The Professor reorganises the lab.

Turns the laptop on, sits and takes a breath. More than half of her energy stayed in that room. There is, however, a sense of duty fulfilled, like a hard race that takes us to the finish line without really knowing how our legs got us there.

It is only at the end of the class that I ask some brief questions.

What is the importance of having practical classes in the academic education that this Faculty provides, whether in Medicine or in Nutrition?

Susana Constantino: It’s to provide the students with the possibility to achieve theoretical knowledge, to arouse their curiosity and creativity, but also to develop their critical sense, allowing them to reflect and consolidate knowledge. This class clearly showed that.

And can new ways for the solution emerge when something is put into practice?

Susana Constantino: Yes, because at the beginning of a practical class the students formulate hypotheses that are perfectly possible. This promotes the student’s imagination grounded in theoretical knowledge. Theory brings the principles that allow them to think and it is very important for them to think. Then, practice allows them to reflect, to be critical and creative and by seeing the end result become able to perceive why that result was achieved.

I found it very interesting to make the students think, even if based on their own mistakes.

Susana Constantino: In practical classes students often make mistakes with the pipette. Almost every practical class would have the same end, where they would tell me “I did not reach the right conclusion because I made pipetting mistakes”, or worse, “maybe the lab pipettes were unbalanced.” That’s not what I want to hear. Faced with the error that will certainly happen during the class, I still want them to develop a reasoning all the way to the end. As a researcher, practice is very important to me, as is theoretical knowledge and I need them to come to an end result. But before reaching this same result, different students can think in different ways and provide possible hypotheses for what they will get. Looking only at the end result does not exercise the student’s thinking. It is very funny when they make a brilliant reasoning and the conclusion does not meet their expectations, because this causes the practical result to destroy their hypothesis and forces them to reformulate their thought. In today’s first lesson, the first class came to the right conclusion, and in this second class they were much more uneven. This last class was very rich for them because they raised huge hypotheses, they were constantly exercising their reasoning and although it can wear down the Professor and make the class run a little bit off the planned track, it is very rewarding and we have to let them go with it. We just have to be careful because a practical class has limited duration, and it comes a time when the Professor has to stop the discussion. But as long as it is reasoned, I let them go with it. In the third practical class we’ll have even more mistakes because they will pipette so many things that some of them will go wrong. I do not finish that class without them having to give me an explanation that is not just a pipetting error. I want them to tell me what was more or less pipetted, to come up with a reasoning.

Are there many differences between Nutrition Students and Medical Students?

Susana Constantino: I would say that there are many differences between students of the same course, some have already tried another course where they have gained some maturity in thinking and even in executing. Then there are very assertive classes and others that are not. There’s classes with one or two more outgoing and creative students that influence the others. Then there’s classes were no one is like that and everyone is very restrained.

What is the importance of a protocol in a class?

Susana Constantino: It’s like a recipe that you follow in the kitchen. It’s very important. Everyone should read it and study it in advance; but it was the first class and they are still getting acquainted with the rules.

Would you have had this overflow of doubts and certainties today if you had not provoked them so much to intervene?

Susana Constantino: I’m sure I wouldn’t. The students would be the same, but what the Professor exercises them to do and how he motivates them to develop their reasoning, makes them completely different. The student leaves the class differently according to the stimulus and the style of class that he has.